Biomedical subjects
Publications and source records attributed to S Sakai.
In three cases a nasalis musculocutaneous flap, using the dog-ear, has been used to help close the secondary defect after transfer of a superiorly based nasolabial flap to the nose. In one case part of the nasalis flap was used to close a defect in the nasal lining.
This report presents a successful case of lip and chin reconstruction by a compound radial artery forearm free flap. This was a versatile source of tissue in the absence of local tissue for reconstruction.
We examined the effects of nilvadipine, a new dihydropyridine calcium entry blocker, on atherogenesis in rabbits fed a 1% cholesterol diet. The drug was given subcutaneously to the animals in hypotensive doses of 1.0 or 3.2 mg/kg/day for 10 weeks, and was well tolerated. Plasma total cholesterol increased markedly in all the cholesterol-fed rabbits, and nilvadipine had no effect on this, or on HDL-cholesterol and triglyceride levels. However, the area of Sudan IV positive intimal lesions (one of the parameters of atherosclerosis) in the aorta decreased significantly in the nilvadipine treated animals, and in addition, cholesterol and calcium content in the thoracic aorta were reduced. The reference drugs, nifedipine and nicardipine given subcutaneously in doses of 10.0 mg/kg/day either had no effect or were weaker in antiatherogenic effect than nilvadipine. The findings suggest that nilvadipine has more potent antiatherogenic activity than nicardipine or nifedipine.
Six patients of olfactory neuroblastoma were treated, and two of them were studied with electron microscopy and immunohistochemical staining. These patients, four male and two female, ranged in age from 37 to 73 years old. Five patients had nasal bleeding, and only one patient had frontal pain and optic disorder without nasal bleeding. None of the patients had metastasis. However, three patients had local recurrence and invasion into the intracranial region. The tumors of three patients were confined to the nasal cavity and one or more paranasal sinuses. The tumors of the other three patients extended beyond the nasal cavity and paranasal sinuses. Two patients, treated with radiotherapy and cryosurgery, died of the disease 7 and 21 years after treatment, respectively. Two patients, treated with radiotherapy alone or a combination of radiotherapy and chemotherapy, died of other causes without recurrence 2 and 3 years later, respectively. A patient treated with craniofacial resection alone is still alive after 4 years. However, he has local recurrence and has been treated with radiotherapy and adjuvant chemotherapy. The last patient, treated with craniofacial resection following radiotherapy, is still alive after 3 years without any symptoms of recurrence. The two most recent cases were studied with electron microscopy, stains for PAS, Grimelius and Bodian, and immunohistochemical staining for S-100 protein, neuron-specific enolase, and glial fibrillary acidic protein. The tumor cells of one case were well differentiated because they contained neurosecretory granules and neurites, and the tumor cells of the other case were poorly differentiated because they contained only neurites-like structures.
The application of the subcutaneous pedicle flap for perineal defects is presented. We recognize from clinical experience that the perineal area has a sufficient subcutaneous vascular network from internal and external pudendar arteries. We found that the subcutaneous pedicle flaps can be used safely in the perineal area the same as the facial area. The perineal defect that reaches to the vaginal orifice or anus needs to be reconstructed three dimensionally, not flat. The subcutaneous pedicle flap with vertical pedicle can produce natural shape and depth of the perineum.
Subcutaneous free or moving bodies are rare. We report two cases of subcutaneous movable bodies. These two bodies were treated by surgical excision. Histopathological findings were free fatty tissues and calcifying epithelioma. The cause of free fatty bodies and the mechanism by which they turn into a widely moving calcifying epithelioma are now obscure; however, trauma may be a possible cause of these lesions.
After wide excision of the squamous cell carcinoma, the large defect of the ulnar side of the left hand was treated successfully by a distally based ulnar artery island forearm flap. The flap has excellent circulation and can cover the wide defect of the hand.
An unusual case of arteriovenous malformation (AVM) associated with ulcer arising on the sole of the left foot is reported. This ulcer was precipitated by pregnancy. After a split thickness skin graft repaired the ulcer, diffuse AVM was found on the left lower leg by arteriography. All the involved vessels were totally excised and the course was comparatively good. Clinical manifestations of AVM, incidences of ulcer in AVM, histological differentiation from Kaposi sarcoma, and treatment of AVM are discussed.
Two Senegalese baboons (Papio papio) were subjected to daily electrical stimulation at the SMA. When compared with the results of kindling at different frontal cortical sites, ADT and GST at the SMA were lower than those at other sites. On the other hand, the number of stimulations required for Stage 4 asymmetrical generalization was much greater at the SMA (mean of 78.0) than that for the PMA (22.5). These findings suggest that partial seizure originating from the PMA rather than the SMA seems to have a better access to the mechanisms underlying secondarily generalized convulsive seizure despite exquisite susceptibility to AD generation at the latter.
Extensive excision of malignant tumors in the medial portion of the eyelids involving the medial canthal tendon and orbicularis oculi muscle results in the lateral displacement of the eyelids and forward drift of the medial canthal region during the healing process if they are not repaired. We present three successful cases of reconstruction of an extensive defect in the medial portion of the eyelids by the island median forehead flap with frontal muscle and frontal galea aponeurotica to repair the medial canthal tendon and orbicularis oculi muscle. This improved technique successfully avoids lateral displacement of the eyelids and forward drift of the medial canthal region, and is a treatment choice for the extensive medial canthal defect.
We investigated the hospital acquired infection of P. aeruginosa in urological wards by determining the serotype and testing the sensitivity of this bacteria to antibiotics. The results were as follows: 1. 92 strains of G-serotype (22.2%), 76 of A-serotype (18.3%) and 65 of B-serotype (15.7%) were predominantly found in the serotype distribution of 415 P. aeruginosa strains isolated from urine or feces. 2. Comparing the sensitivity of P. aeruginosa to various antibiotics determined by MIC50 (the concentration to inhibit growth of 50% of the objective bacteria), Dibekacin showed MIC50 of 0.78 microgram/ml, Ceftazidime 1.56 micrograms/ml, Cefsulodin 3.13 micrograms/ml, and Polymixin-B, Piperacillin, Aztreonam 6.25 micrograms/ml. The analysis of the relationship between serotype and sensitivity to antibiotics demonstrated that K-serotype of P. aeruginosa tended to be highly sensitive and M-serotype be less sensitive to only Dibekacin. There was no definite relation of serotype to sensitivity against any other antibiotics. The comparison of sensitivity to antibiotics determined by MIC50,80 between P. aeruginosa isolated from urine and that from feces revealed that the former was less sensitive by one to four grades than the latter. The sensitivity of P. aeruginosa isolated from feces at admission was not different from that at discharge. In the chronological changes in sensitivity of P. aeruginosa isolated from urine, the strains highly resistant to Cefsulodin, Ceftazidime, Aztreonam and Dibekacin had increased in 1984 and 1985. 3. These highly resistant strains tended to break out in the urological wards, which suggested the need for more intensive prophylactic measures against hospital acquired infection.
The gastric microflora of 21 cases receiving histamine H2-receptor antagonists (H2-blocker) were studied. Patients not given H2-blocker were also examined for gastric microflora. The gastric pH of patients who were receiving H2-blocker ranged from 1.91 to 6.51 (mean, 4.32). The gastric pH of over 5.00 was seen in 10 cases. Aerobic bacteria were isolated from 20 cases (95%). Aerobic bacterial counts per ml of gastric aspirates correlated positively with the pH of those aspirates but was little correlation between the pH of the gastric aspirates and the number of anaerobic bacteria of the samples, which were positive in 7 cases (33%). Candida and Staphylococcus were predominant isolates with positive rates of 82% and 41%, respectively. While Fusobacterium was isolated from 33% of the samples, none of the Bacteroides fragilis group organisms were isolated. It was also observed in the control group that aerobic and anaerobic bacteria were isolated from the gastric aspirates with high pH. These results suggest that in patients receiving H2-blocker anaerobes as well as aerobes may have the possibility to become pathogen for aspirate pneumonia and so on because of the overgrowth of anaerobic bacteria in the gastric fluid.
The gene (amyP) coding for maltotetraose-forming amylase (exo-maltotetraohydrolase) of Pseudomonas stutzeri MO-19 was cloned. Its nucleotide sequence contained an open reading frame coding for a precursor (547 amino acid residues) of secreted amylase. The precursor had a signal peptide of 21 amino acid residues at its amino terminus. An extract of Escherichia coli carrying the cloned amyP had amylolytic activity with the same mode of action as the extracellular exo-maltotetraohydrolase obtained from P. stutzeri MO-19. A region in the primary structure of this amylase showed homology with those of other amylases of both procaryotic and eucaryotic origins. The minimum 5' noncoding region necessary for the expression of amyP in E. coli was determined, and the sequence of this region was compared with those of Pseudomonas promoters.
Follow-up studies on 3,195 patients from 161 centers in Japan undergoing continuous ambulatory peritoneal dialysis (CAPD) were performed for 1-104 months to clarify the incidence as well as the clinical features of acute hydrothorax. In these studies, 50 patients (1.6%) developed this complication. Twenty-seven (54%) were men, and 23 (46%) were women, ranging in age from 6 to 79 (average 49) years. The interval between onset of CAPD and hydrothorax ranged from 1 day to 8 years. Four had left-sided, and 2 had bilateral hydrothorax, but the majority (88%) were right-sided. Dyspnea was experienced by 37 of these 50 patients, but the remaining 13 (26%) patients were asymptomatic. Hydrothorax was fully resolved in 27 of them following a brief interruption of CAPD or the combined use of small exchange volumes in a semi-sitting position and pleurodesis with tetracycline or other agents. The remaining 23 patients (46%) were switched to hemodialysis permanently. Despite recurrence, 1 patient continued successfully on CAPD. It was concluded that acute hydrothorax is one important possible complication, although the risk may be low. Constant surveillance is necessary to detect pleural effusions in patients during CAPD.
Right ventricular cardiac tissue (10-20 mg wet weight) was obtained from anesthetized adult dogs by endomyocardial biopsy. The biopsy could be repeated in one dog every 2 weeks for up to 3 months. Fifty to 200 cardiomyocytes, dispersed with collagenase and trypsin, were collected by centrifugation of the cells with 50% polysucrose-sodium diatrizoate solution (Ficoll-Paque). Single cardiomyocytes were suspended in a minimum essential medium containing 20% fetal bovine serum and 8-bromoadenosine 3': 5'-cyclic monophosphate (0.1 mM) for up to 3 weeks. Approximately 70-80% of the cultured cardiomyocytes were rod shaped after 24 hours (10-20% after 7 days). Cytoplasmic organelles of the cultured cells, examined with a transmission electron microscope, were within the normal range of canine heart morphology in vivo. Resting membrane potential of the cells was about -80 mV when superfused with a Krebs' solution containing 4.7 mM potassium ions. The action potential lasted for 300 msec and had a peak amplitude of about 120 mV. Voltage-clamp experiments demonstrated the presence of an inward calcium current (congruent to 0.9 nA at +9 mV), which was facilitated by isoproterenol (0.1-1 microMs). The background potassium current showed typical inward rectification at potentials more negative than -80 mV. The results indicate that morphological, electrophysiological, and pharmacological properties of the cultured cardiomyocytes were intact. We propose that the culture techniques we have developed can be useful for repeated investigation on functional aspects of cardiac muscles in myocardial disease.
3-[2-[p-(Un)substituted phenyl]imidazo [2,1-b]benzothiazol-3- yl]propionic acid derivatives (2a--e) were prepared via the interaction of the corresponding 2-[p-(un)substituted phenyl]imidazo[2,1-b]benzothiazoles (1a--e) with acrylic acid in the presence of acetic anhydride and acetic acid. Esterification of 2a--e produced methyl esters (3a--e). Upon the interaction of 3a with m-chloroperbenzoic acid, the S-dioxide (4a) was obtained. Compound 5a was prepared from 4a by alkaline hydrolysis. Vilsmeier formylation for 1a--e produced novel [2-[p-(un)substituted phenyl]imidazo[2,1-b]benzothiazol-3- yl]formaldehyde derivatives (6a--e). Derivatives 6a--e reacted with ethyl bromoacetate to give ethyl 3-hydroxy-3-[2-[p-(un)substituted phenyl]imidazo[2,1-b]benzothiazol- 3-yl]propionate esters (7a--e). Compound dl-7a was resolved with l-(+)-tartaric acid. Compounds 2a--e showed weak or no activity in the carrageein-induced paw edema assay. Compound 4a significantly inhibited the leakage of pontamine-sky blue dye into the peritoneal cavity of mice, in the capillary permeability inhibition assay. Compound 5a inhibited the writhing by 62% in the acetic acid-induced writhing assay.
Transbronchial lung biopsy performed on a 51-year-old woman for the evaluation of nodular densities with cavities in the bilateral apical areas was complicated by the breakage of the biopsy forceps. The broken fragment of the forceps was successfully retrieved by use of the magnetic extractor through a fiberoptic bronchoscope under fluoroscopic guidance.
The binding assay of prolactin (PRL) to the receptor in the rabbit mammary gland was carried out with varying concentrations of NaCl, KCl, CaCl2, MgCl2, glycerol, glucose, sucrose and urea. The agents did not affect the binding capacity. The ionic bond-breaking agents (NaCl and KCl) had little effect on changes in the association rate constant (k+1) of PRL binding to the receptor and the dissociation rate constant (k-1) of bound PRL. The inclusion of other agents changed the k+1 and the k-1. Among the agents examined, chaotropic salts (CaCl2 and MgCl2) inhibited the binding of PRL greatly, and were the most effective in decreasing the k+1. Both hydrogen- and hydrophobic bonds are involved in the interaction between PRL and the receptor. The data suggest that hydrophobic bonding is primarily an important force participating in the binding of PRL to its receptor.